Five Deaths at a V.A. Complex Draw Lawmakers’ Concern

New York Times

LOS ANGELES, April 2 — Five deaths in recent months at the nation’s largest Veterans Affairs medical complex are troubling and could be a further sign of a system badly in need of closer oversight, two members of Congress said here Monday.

The deaths occurred in residential rehabilitation or emergency housing programs at the West Los Angeles Healthcare Center from November to February.

“What is going on here?” Representative Jane Harman, a Democrat whose district includes neighborhoods adjacent to the complex, said at a House Veterans’ Affairs Committee meeting on veterans’ health care in the Los Angeles area.

The committee chairman, Representative Bob Filner, a Democrat from San Diego, noted that the five deaths here, mostly involving veterans with a history of substance abuse or mental health problems, coincided with anecdotal reports of suicides among other deaths at additional V.A. hospitals across the country.

Mr. Filner said the Veterans Affairs Department had not been sufficiently forthcoming about such episodes.

“There are errors all the time,” he said, “and we have to get that down to zero. But what I object to is a V.A. that seems to want to cover it up.”

The hospital’s director, Charles Dorman, told the panel that the deaths were “unfortunate” but were an occasionally inevitable outcome of treating people troubled by substance abuse or mental problems.

“We take a big chance, a big risk, taking care of a difficult population,” Mr. Dorman said after testifying. “And I’m proud of the work we do.”

Three of the five deaths occurred at a rehabilitation clinic called the Domiciliary, which treats veterans with physical, mental or substance abuse problems in a setting much like that of a dormitory.

One of the men, Justin Bailey, 27, an Iraq war veteran who was suffering from a groin injury and post-traumatic stress disorder, overdosed on the prescription painkiller methadone and died on Jan. 27, officials said.

Members of Mr. Bailey’s family said that they had warned officials that he might have abused prescription medication in the past. But V.A. officials said that this had not been clear to the staff and that he had been allowed to take the medicine without supervision, in keeping with common practice at the facility.

Five days later, Mark Torres, 55, who was undergoing treatment for abuse of heroin, died at the Domiciliary, apparently of an overdose of that drug. A third man died there that day, but officials said his death appeared to stem from medical complications, not substance abuse.

The deaths of Mr. Bailey and Mr. Torres prompted changes in security and procedures at the Domiciliary, including additional clinical workers and searches for contraband drugs, Dr. Dean C. Norman, the hospital’s chief of staff, said in a recent interview. The V.A.’s medical inspector is investigating the deaths, as is a panel of doctors commissioned by the department.

The two other deaths occurred in November and February at the Haven, an emergency shelter for homeless veterans on the grounds that is run by the Salvation Army. They involved veterans in their 50s with a history of medical complications and substance abuse, V.A. officials said, though the coroner has not yet ruled on the cause of death in these cases.

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